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Abstract：
UNASSIGNED: The efficacy of second-line immune checkpoint inhibitor (ICI) therapy is limited in non-small cell lung cancer (NSCLC) patients with ≤ 49% PD-L1 expression. Although chemoimmunotherapy is a promising strategy, platinum-based chemotherapy followed by ICI monotherapy is often used to avoid synergistic adverse events. However, predictors of the efficacy of ICI monotherapy after platinum-based chemotherapy in NSCLC with ≤ 49% PD-L1 expression remain scarce.
UNASSIGNED: This multicenter retrospective study evaluated 54 advanced or recurrent NSCLC patients with ≤ 49% PD-L1 expression who were treated with second-line ICI monotherapy following disease progression on first-line platinum-based chemotherapy at nine hospitals in Japan. The impact of response to platinum-based chemotherapy on the efficacy of subsequent ICI monotherapy was investigated.
UNASSIGNED: The response to first-line platinum-based chemotherapy was divided into two groups: the non-progressive disease (PD) group, which included patients who did not experience disease progression after four cycles of chemotherapy, and the PD group, which included patients who showed initial PD or could not maintain disease control during the four cycles of chemotherapy and switched to second-line ICI monotherapy. Among the 54 patients, 32 and 22 were classified into the non-PD and PD groups, respectively. The non-PD group showed better response rates (p = 0.038) and longer overall survival (OS) with ICI monotherapy (p = 0.023) than the PD group. Multivariate analysis identified that maintaining a non-PD status after four cycles of chemotherapy was an independent prognostic factor for ICI monotherapy (p = 0.046). Moreover, patients with a modified Glasgow Prognostic Score (mGPS) of 0 showed a tendency for longer OS with ICI monotherapy (p = 0.079), and there was a significant correlation between maintaining non-PD after four cycles of chemotherapy and an mGPS of 0 (p = 0.045).
UNASSIGNED: Maintaining a non-PD status after four cycles of platinum-based chemotherapy was a predictor of OS after second-line ICI monotherapy. These findings will help physicians select the most suitable treatment option for NSCLC patients who were treated with platinum-based chemotherapy and switched to second-line treatment. Those who experienced early PD during platinum-based chemotherapy should not be treated with ICI monotherapy in the second-line setting.
UNASSIGNED: This multicenter retrospective study evaluated 54 advanced or recurrent NSCLC patients with ≤ 49% PD-L1 expression who were treated with second-line ICI monotherapy following disease progression on first-line platinum-based chemotherapy at nine hospitals in Japan. The impact of response to platinum-based chemotherapy on the efficacy of subsequent ICI monotherapy was investigated.
UNASSIGNED: The response to first-line platinum-based chemotherapy was divided into two groups: the non-progressive disease (PD) group, which included patients who did not experience disease progression after four cycles of chemotherapy, and the PD group, which included patients who showed initial PD or could not maintain disease control during the four cycles of chemotherapy and switched to second-line ICI monotherapy. Among the 54 patients, 32 and 22 were classified into the non-PD and PD groups, respectively. The non-PD group showed better response rates (p = 0.038) and longer overall survival (OS) with ICI monotherapy (p = 0.023) than the PD group. Multivariate analysis identified that maintaining a non-PD status after four cycles of chemotherapy was an independent prognostic factor for ICI monotherapy (p = 0.046). Moreover, patients with a modified Glasgow Prognostic Score (mGPS) of 0 showed a tendency for longer OS with ICI monotherapy (p = 0.079), and there was a significant correlation between maintaining non-PD after four cycles of chemotherapy and an mGPS of 0 (p = 0.045).
UNASSIGNED: Maintaining a non-PD status after four cycles of platinum-based chemotherapy was a predictor of OS after second-line ICI monotherapy. These findings will help physicians select the most suitable treatment option for NSCLC patients who were treated with platinum-based chemotherapy and switched to second-line treatment. Those who experienced early PD during platinum-based chemotherapy should not be treated with ICI monotherapy in the second-line setting.
摘要：
■二线免疫检查点抑制剂（ICI）治疗在PD-L1表达≤49％的非小细胞肺癌（NSCLC）患者中的疗效有限。尽管化学免疫疗法是一种有前途的策略，以铂类为基础的化疗和ICI单药治疗通常用于避免协同不良事件.然而,在PD-L1表达≤49%的NSCLC中,铂类化疗后ICI单药治疗疗效的预测因子仍然很少.
这项多中心回顾性研究评估了54例PD-L1表达≤49%的晚期或复发性NSCLC患者，这些患者在疾病进展后接受二线ICI单药治疗，并在日本9家医院进行了一线铂类化疗。研究了对基于铂的化疗的反应对随后的ICI单一疗法的疗效的影响。
■对一线铂类化疗的反应分为两组：非进行性疾病（PD）组，其中包括四个周期化疗后没有出现疾病进展的患者，和PD组,其中包括在4个周期的化疗期间出现初次PD或无法维持疾病控制并改用二线ICI单药治疗的患者.在54名患者中，32和22分为非PD和PD组，分别。与PD组相比，非PD组显示出更好的缓解率（p=0.038）和ICI单药治疗（p=0.023）更长的总生存期（OS）。多变量分析确定，在四个周期的化疗后维持非PD状态是ICI单药治疗的独立预后因素（p=0.046）。此外，改良的格拉斯哥预后评分（mGPS）为0的患者在ICI单药治疗下显示出OS更长的趋势（p=0.079），化疗四个周期后维持非PD与mGPS为0之间存在显着相关性（p=0.045）。
■在四个周期的铂类化疗后维持非PD状态是二线ICI单药治疗后OS的预测因子。这些发现将帮助医生为接受铂类化疗并转为二线治疗的NSCLC患者选择最合适的治疗方案。那些在铂类化疗期间经历早期PD的患者不应在二线治疗中接受ICI单一疗法治疗。
这项多中心回顾性研究评估了54例PD-L1表达≤49%的晚期或复发性NSCLC患者，这些患者在疾病进展后接受二线ICI单药治疗，并在日本9家医院进行了一线铂类化疗。研究了对基于铂的化疗的反应对随后的ICI单一疗法的疗效的影响。
■对一线铂类化疗的反应分为两组：非进行性疾病（PD）组，其中包括四个周期化疗后没有出现疾病进展的患者，和PD组,其中包括在4个周期的化疗期间出现初次PD或无法维持疾病控制并改用二线ICI单药治疗的患者.在54名患者中，32和22分为非PD和PD组，分别。与PD组相比，非PD组显示出更好的缓解率（p=0.038）和ICI单药治疗（p=0.023）更长的总生存期（OS）。多变量分析确定，在四个周期的化疗后维持非PD状态是ICI单药治疗的独立预后因素（p=0.046）。此外，改良的格拉斯哥预后评分（mGPS）为0的患者在ICI单药治疗下显示出OS更长的趋势（p=0.079），化疗四个周期后维持非PD与mGPS为0之间存在显着相关性（p=0.045）。
■在四个周期的铂类化疗后维持非PD状态是二线ICI单药治疗后OS的预测因子。这些发现将帮助医生为接受铂类化疗并转为二线治疗的NSCLC患者选择最合适的治疗方案。那些在铂类化疗期间经历早期PD的患者不应在二线治疗中接受ICI单一疗法治疗。
